The goal of the Virginia Mason Community Clinical Oncology Program (VM-CCOP) is to improve the quality of cancer care in the Pacific Northwest through participation in cancer treatment and cancer control research. The VM-CCOP will be expanded from 3 institutions, into a network of 10 institutions stretching from Northwest to Southwest Washington. The core for the network will be the Virginia Mason Medical Center (VMMC), a regional multispecialty tertiary care medical center in Seattle, consisting of a 336-bed hospital, a 180-physician multispecialty group practice, a research center, a primary care satellite system, and a new HMO. The VM Cancer Center program features integrated multidisciplinary cancer care with a strong tradition of clinical cancer research and education. During the first 3 years of CCOP activity, the VM- CCOP developed a successful organization and data management system which accrued 180 patients on Southwest Oncology Group, Radiation Oncology Group and Fred Hutchinson Cancer Research Center protocols. The expanded VM-CCOP network will potentially provides access to urban and rural populations and a cancer patient population of 2600. The investigators, representing many disciplines involved in cancer care, have extensive experience in both cancer treatment protocol research and cancer control activities and research. Specific aims for this renewal application include: 1) A significant increase. In patient accrual to cancer treatment protocols; 2) Create a diverse broad based population pool for participation in cancer control research; 3) Significant patient accrual to cancer control protocols; 4) Provide the operational and data management support to accomplish aims 1, 2, and 3; 5) Make available the results of the cancer treatment and cancer control research to a wide spectrum of communities; 6) Increase investigator particiaption in the scientific affairs of the research bases; 7) Promote sharing of resources and ideas within the network to improve community cancer programs. The planned expansion enables VM-CCOP to be uniquely capable of fulfilling the new CCOP goals in both cancer treatment and cancer control research.